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Epidemiological analysis of pulmonary artery dilation prevalence in Moscow: automated computed tomography image analysis 莫斯科肺动脉扩张流行病学分析:自动计算机断层扫描图像分析
Pub Date : 2024-07-03 DOI: 10.17816/dd627074
A. Solovev, V. E. Sinitsyn, Maria V. Sokolova, N. Kudryavtsev, A. Vladzymyrskyy, D. Semenov
BACKGROUND: The state of health of the pulmonary system and its impact on the overall well-being of the individual is an important aspect of modern medicine. Despite continuous progress in diagnostics and technology, epidemiologic data on pulmonary trunk health at the population level in Russia remain understudied. In the context of this problem, the present study is an in-depth population-based analysis of the status of pulmonary trunk dilatation using modern technology and artificial intelligence [1]. Pulmonary trunk dilatation (≥29 mm) may be associated with various pathologies including arterial hypertension, chronic obstructive pulmonary disease, heart failure, and other diseases of the circulatory system [2]. AIM: The aim of the study was to assess the prevalence of pulmonary trunk dilatation in the Moscow population using artificial intelligence technologies. MATERIALS AND METHODS: The study was conducted between September 2022 and February 2023 in the population of Moscow. A large amount of chest CT data was analyzed, including information on 134,218 patients (61,514 men and 72,704 women). Artificial intelligence technologies were used to automatically process this data. RESULTS: The results show that 49,227 (36.7%) patients — 23,720 (38.6%) men and 25,507 (35.1%) women — had evidence of pulmonary trunk dilatation. The analysis shows gender and age differences in the incidence of the pathology. The distribution of pulmonary trunk dilatation in the population shows age dependence. The percentage of patients with signs of pulmonary trunk dilatation increases with age: from 18.1% in the group of young people to 62.2% in the group of elderly people. CONCLUSIONS: The study provides the first epidemiological data on pulmonary trunk dilatation in Moscow and emphasizes the importance of further research in this area. The findings may serve as a basis for the development of effective diagnostic and treatment strategies, as well as for further research in the field of artificial intelligence in medicine.
背景:肺部系统的健康状况及其对个人整体健康的影响是现代医学的一个重要方面。尽管诊断和技术在不断进步,但有关俄罗斯人口肺干健康的流行病学数据仍未得到充分研究。针对这一问题,本研究利用现代技术和人工智能对肺动脉干扩张状况进行了深入的人群分析[1]。肺动脉干扩张(≥29 毫米)可能与多种病症有关,包括动脉高血压、慢性阻塞性肺疾病、心力衰竭和循环系统的其他疾病[2]。目的:本研究旨在利用人工智能技术评估莫斯科人群中肺动脉干扩张的患病率。材料与方法:研究于 2022 年 9 月至 2023 年 2 月期间在莫斯科人群中进行。研究分析了大量胸部 CT 数据,包括 134218 名患者(男性 61514 人,女性 72704 人)的信息。人工智能技术用于自动处理这些数据。结果:结果显示,49227 名患者(36.7%)--23720 名男性(38.6%)和 25507 名女性(35.1%)--有肺动脉干扩张的证据。分析表明,该病症的发病率存在性别和年龄差异。肺动脉干扩张在人群中的分布与年龄有关。有肺动脉干扩张迹象的患者比例随着年龄的增长而增加:从年轻人组的 18.1%到老年人组的 62.2%。结论:该研究首次提供了莫斯科肺动脉干扩张的流行病学数据,并强调了在该领域开展进一步研究的重要性。研究结果可作为制定有效诊断和治疗策略的依据,也可作为在医学人工智能领域开展进一步研究的依据。
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引用次数: 0
Composite materials based on quantum dots and polymer matrices for gamma radiation registration in the next-generation scintillation detectors 基于量子点和聚合物基质的复合材料,用于下一代闪烁探测器的伽马辐射登记
Pub Date : 2024-07-03 DOI: 10.17816/dd627009
Alexander A. Knysh, V. Sosnovtsev, I. Nabiev, P. Samokhvalov
BACKGROUND: The development of new scintillation materials based on fluorescent nanocrystals with a perovskite structure of CsPbBr3 composition and CdSe/ZnS quantum dots is a pressing topic that is being pursued by numerous scientific groups [1–4]. Both of these materials have a high potential for application in this role due to their excellent fluorophore properties, with a quantum yield of luminescence of approximately 100%. Additionally, they possess high values of the effective atomic Zeff number. The photoelectric cross section is dependent on Zeff as (Zeff)5, while the magnitude of X-ray absorption is dependent on Zeff as (Zeff)4/(AE3), where A is the atomic mass of the substance absorbing the γ-quantum and E is the energy of the X-ray photon [5]. AIM: The aim of the study was to develop a technique for fabricating scintillators based on quantum dots and polymer matrices with a high degree of transparency, high temporal stability of luminescence quantum yield, and short luminescence decay times (time of illumination or average lifetime of the substance in the excited state) for gamma-ray registration. MATERIALS AND METHODS: A HAMAMAMATSU R7400U-6 photomultiplier tube was employed to register scintillation signals. A 137Cs source with a γ-quantum energy of 661.7 keV was used as a source of ionizing radiation. RESULTS: At irradiation with γ-quanta of 137Cs isotope samples based on poly(para-methylstyrene) matrix cross-linked with divinylbenzene molecules (10% wt%), activated with naphthalene (10%, primary acceptor), anthracene (1%) and quantum dots/perovskite nanocrystals (0, 1–1.0%, re-emitter), the energy spectrum showed effective Compton scattering of gamma-quanta in matter on atoms included in quantum dots/perovskite nanocrystals. The study revealed that samples devoid of inorganic elements, including quantum dots and perovskite nanocrystals, do not exhibit the Compton effect for gamma-quanta. Furthermore, the paramethylstyrene matrix serves to safeguard perovskite nanocrystals from external influences. The photoluminescence quantum yield of bulk composite materials based on perovskite nanocrystals of the CsPbBr3 composition and poly(paramethylstyrene) remains constant over an extended period, with minimal fluctuations within the margin of error. CONCLUSIONS: Experimental evidence has demonstrated that quantum dots and perovskite nanocrystals encapsulated in various polymer matrices exhibit scintillator properties when subjected to ionizing radiation. The fabricated samples of perovskite nanocrystals/quantum dots and various polymers have been identified as the most promising candidates for use as scintillation material for the registration of X-ray and gamma radiation.
背景:许多科研小组都在开发基于 CsPbBr3 组成的包晶结构荧光纳米晶体和 CdSe/ZnS 量子点的新型闪烁材料 [1-4]。这两种材料都具有出色的荧光团特性,发光量子产率约为 100%,因此在这方面具有很大的应用潜力。此外,它们还具有较高的有效原子泽夫数。光电截面与 Zeff 的关系为 (Zeff)5,而 X 射线吸收的大小与 Zeff 的关系为 (Zeff)4/(AE3),其中 A 是吸收 γ 量子的物质的原子质量,E 是 X 射线光子的能量 [5]。目的:本研究旨在开发一种基于量子点和聚合物基质的闪烁体制造技术,这种闪烁体具有高透明度、高发光量子产率时间稳定性和短发光衰减时间(照射时间或物质在激发态的平均寿命),可用于伽马射线登记。材料与方法:使用 HAMAMATSU R7400U-6 光电倍增管来记录闪烁信号。使用γ-量子能量为 661.7 千伏的 137Cs 源作为电离辐射源。结果:137Cs 同位素样品基于与二乙烯基苯分子(10% wt%)交联的聚(对甲苯乙烯)基体,用萘(10%,主受体)、蒽(1%)和量子点/过氧化物纳米晶体(0,1-1.0%,再发射器)激活,能谱显示物质中的伽马量子对量子点/高闪石纳米晶体中的原子产生了有效的康普顿散射。研究表明,不含无机元素的样品,包括量子点和透辉石纳米晶体,对伽马量子不表现出康普顿效应。此外,对甲基苯乙烯基质还能保护殒石纳米晶体不受外界影响。基于 CsPbBr3 组成的闪长岩纳米晶体和聚(对甲基苯乙烯)的块状复合材料的光致发光量子产率在较长时间内保持稳定,误差范围内的波动极小。结论:实验证明,封装在各种聚合物基质中的量子点和包闪石纳米晶体在电离辐射下具有闪烁特性。制作的闪烁体纳米晶体/量子点样品和各种聚合物已被确定为最有希望用作闪烁材料的候选材料,可用于登记 X 射线和伽马射线辐射。
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引用次数: 0
Magnetic resonance imaging as a method for evaluating the effect of drinking mineral water on motor-evacuation function 磁共振成像作为评估饮用矿泉水对运动撤离功能影响的一种方法
Pub Date : 2024-07-03 DOI: 10.17816/dd626507
K. E. Panteleev, Kirill V. Maksimov, Alexey E. Shklyaev
BACKGROUND: One of the primary pathophysiological mechanisms of functional dyspepsia is a disruption in the postprandial reflex relaxation of the proximal part of the stomach, which results in an impairment of its motor-evacuation function. This impairment can be verified by magnetic resonance imaging with a stress drinking test. Correction of gastric relaxation accommodation disorders in functional dyspepsia is possible with the help of drinking mineral waters. However, further studies are required to assess the effect of these waters on the motor-evacuation function of the stomach. AIM: The study was aimed at comparative evaluation of the effect of intake of therapeutic medium mineralized sulfate-sodium-calcium mineral water and ordinary drinking water on gastric evacuation function using magnetic resonance tomography. MATERIALS AND METHODS: A two-fold magnetic resonance imaging procedure was conducted on an empty stomach using a closed-type Philips Intera 1.5T device (Philips, Netherlands) in 10 patients aged 22.8±1.2 years with a diagnosis of functional dyspepsia. On day 1, 200 ml of drinking water was used, and on day 2, 200 ml of mineral water was used. The examination was conducted in abdominal mode, with the subjects lying on their back. A slice thickness of 3 mm was used in coronal, axial, and sagittal projections, with images acquired every 5 minutes for 20 minutes. The following imaging modes were employed: T1, T2-weighted images, T2 Spair, and b-FFE. The volume of gastric contents and the rate of fluid evacuation were calculated using the RadiAnt DICOM Viewer program (Medixant, Poland). RESULTS: In patients with functional dyspepsia, the volume of liquid in the stomach after ingestion of 200 ml of drinking water was 163.71 ± 28.9 mL, while after ingestion of mineral water, the volume was 101.57 ± 26.88 mL. Furthermore, the volume of evacuated liquid after ingestion of mineral water was 1.040–2.5 times greater. By minute 15, the volume of liquid in the stomach was 8.0 ± 6.16 mL after mineral water intake and 58.85 ± 40.06 mL after drinking water. The mean gastric evacuation rate following ingestion of ordinary drinking water was 12.9 ± 5.29 mL/min, while that following ingestion of mineral water was 24.1 ± 4.53 mL/min (1.07–3.76 times greater). The increase in gastric evacuation rate observed in the examined subjects when using mineral water ranged from 7.58% to 276.21%. CONCLUSIONS: Magnetic resonance imaging of the stomach allows for the verification of the effect of mineral water on its motor-evacuation function, thus enabling the estimation of the rate of gastric emptying. A single intake of the studied mineral water has a prokinetic effect, which can be used to correct motor disorders in patients with functional dyspepsia.
背景:功能性消化不良的主要病理生理机制之一是胃近端餐后反射性松弛发生障碍,导致其运动排空功能受损。这种功能障碍可以通过磁共振成像和压力饮水试验来验证。饮用矿泉水可以纠正功能性消化不良的胃松弛调节紊乱。然而,还需要进一步的研究来评估这些矿泉水对胃的运动排空功能的影响。目的:该研究旨在利用磁共振断层扫描技术,比较评估摄入治疗性中度硫酸钠钙矿泉水和普通饮用水对胃排空功能的影响。材料与方法:使用封闭式飞利浦 Intera 1.5T 设备(荷兰飞利浦公司)对 10 名年龄为 22.8±1.2 岁、诊断为功能性消化不良的患者进行了两次空腹磁共振成像检查。第 1 天使用 200 毫升饮用水,第 2 天使用 200 毫升矿泉水。检查以腹部模式进行,受试者仰卧。冠状切片、轴切片和矢状切片厚度均为 3 毫米,每 5 分钟采集一次图像,持续 20 分钟。采用了以下成像模式:T1、T2加权图像、T2 Spair和b-FFE。使用 RadiAnt DICOM Viewer 程序(波兰 Medixant 公司)计算胃内容物的体积和液体排空率。结果:在功能性消化不良患者中,摄入 200 毫升饮用水后,胃内液体体积为 163.71 ± 28.9 毫升,而摄入矿泉水后,胃内液体体积为 101.57 ± 26.88 毫升。此外,摄入矿泉水后排空的液体量是摄入量的 1.040-2.5 倍。到第 15 分钟时,摄入矿泉水后胃中的液体体积为 8.0 ± 6.16 mL,摄入饮用水后为 58.85 ± 40.06 mL。摄入普通饮用水后的平均胃排空率为 12.9 ± 5.29 毫升/分钟,而摄入矿泉水后的平均胃排空率为 24.1 ± 4.53 毫升/分钟(高出 1.07-3.76 倍)。在使用矿泉水时,受试者的胃排空率增加了 7.58% 至 276.21%。结论:胃磁共振成像可验证矿泉水对胃运动排空功能的影响,从而估算胃排空率。单次摄入所研究的矿泉水具有促动力作用,可用于纠正功能性消化不良患者的运动障碍。
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引用次数: 0
Quantitative assessment of iron as a marker of neurodegeneration after traumatic brain injury 作为脑外伤后神经变性标志物的铁定量评估
Pub Date : 2024-07-03 DOI: 10.17816/dd626180
Elena Voronkova, M. Ublinskiy, Anna A. Kobzeva, I. Melnikov
BACKGROUND: Ferroptosis plays a pivotal role in the pathophysiology of secondary disorders following brain injury. Disturbances in iron homeostasis result in the accumulation of iron and the formation of reactive oxygen species, which may contribute to the development of various neurodegenerative diseases. Magnetic susceptibility mapping is a novel, rapidly evolving quantitative technique with significant potential for assessing iron accumulation in the brain. AIM: The study aimed to determine changes in brain iron concentrations in patients with brain injury using magnetic susceptibility mapping techniques. MATERIALS AND METHODS: The study included 9 patients (14±2 years) with moderate and severe brain injury: three in the acute phase and six in the remote phase, and 4 healthy volunteers (15.3±0.9 years). All study participants underwent magnetic resonance imaging on a Philips Achieva dStream 3T scanner (Philips, the Netherlands). Data for magnetic susceptibility maps were acquired using a 3D FFE multi-echo sequence with flux compensation: FA=20, 6 TE: TE1/dTE=4.422 ms/5.795 ms, TR=59 ms (minimum), matrix size was 400×400×75, voxel size was 0.6×0.6×0.6 mm3. Magnetic susceptibility maps were generated using the SEPIA program. Magnetic field map construction, local magnetic field extraction, and magnetic susceptibility calculation were performed using the Laplacian, LBV, and iLSQR techniques, respectively. Average magnetic susceptibility values were obtained in 16 subcortical gray matter zones using the CIT168 atlas. RESULTS: The preliminary results of the study indicated that the patient group exhibited higher magnetic susceptibility values (p=0.07) in the compact part of the substantia nigra compared to the control group. The values for the patient and control groups were 0.03±0.03 and 0.003±0.018, respectively (Fig. 1). This result suggests a potential difference between the two groups at the level of a statistical trend, which may indicate iron accumulation in this area following brain injury. No changes in the values of magnetic susceptibility were observed in other areas of the subcortical gray matter that were investigated. An increased iron concentration in the compact part of the substantia nigra is also a characteristic of Parkinson’s disease [3]. This is consistent with the fact that brain injury is a risk factor for the development of this neurodegenerative disease. One of the possible causes of iron accumulation is neuronal death and increased permeability of the blood-brain barrier [4]. CONCLUSIONS: An elevated magnetic susceptibility value in the compact part of the substantia nigra in patients with brain injury may indicate the accumulation of iron in this area following injury. A larger sample size will allow for further testing of this hypothesis and the monitoring of changes in iron concentration over time following brain injury.
背景:铁变态反应在脑损伤后继发性疾病的病理生理学中起着关键作用。铁平衡失调会导致铁的积累和活性氧的形成,从而引发各种神经退行性疾病。磁感应强度图谱是一种新颖、快速发展的定量技术,在评估大脑铁积累方面具有巨大潜力。目的:本研究旨在利用磁感应强度图技术确定脑损伤患者脑部铁浓度的变化。材料与方法:研究对象包括 9 名中度和重度脑损伤患者(14±2 岁):其中 3 名处于急性期,6 名处于远期,以及 4 名健康志愿者(15.3±0.9 岁)。所有参加研究的人员都在飞利浦 Achieva dStream 3T 扫描仪(荷兰飞利浦公司)上进行了磁共振成像。磁感应强度图的数据采用带磁通量补偿的三维 FFE 多回波序列采集:FA=20,6TE:TE1/dTE=4.422毫秒/5.795毫秒,TR=59毫秒(最小值),矩阵大小为400×400×75,体素大小为0.6×0.6×0.6立方毫米。使用 SEPIA 程序生成磁感应强度图。磁场图构建、局部磁场提取和磁感应强度计算分别采用拉普拉斯技术、LBV 技术和 iLSQR 技术。使用 CIT168 地图集获得了 16 个皮层下灰质区的平均磁感应强度值。结果:研究的初步结果表明,与对照组相比,患者组在黑质的紧密部分表现出更高的磁感应强度值(P=0.07)。患者组和对照组的数值分别为 0.03±0.03 和 0.003±0.018(图 1)。这一结果表明两组之间存在潜在的统计学趋势差异,这可能表明该区域在脑损伤后存在铁积累。皮层下灰质的其他研究区域的磁感应强度值没有发生变化。黑质紧密部分的铁浓度增加也是帕金森病的一个特征[3]。这与脑损伤是这种神经退行性疾病发病的危险因素这一事实是一致的。铁积累的可能原因之一是神经元死亡和血脑屏障通透性增加[4]。结论:脑损伤患者黑质紧密部分的磁感应强度值升高可能表明该区域在损伤后有铁积累。扩大样本量将有助于进一步测试这一假设,并监测脑损伤后铁浓度随时间的变化。
{"title":"Quantitative assessment of iron as a marker of neurodegeneration after traumatic brain injury","authors":"Elena Voronkova, M. Ublinskiy, Anna A. Kobzeva, I. Melnikov","doi":"10.17816/dd626180","DOIUrl":"https://doi.org/10.17816/dd626180","url":null,"abstract":"BACKGROUND: Ferroptosis plays a pivotal role in the pathophysiology of secondary disorders following brain injury. Disturbances in iron homeostasis result in the accumulation of iron and the formation of reactive oxygen species, which may contribute to the development of various neurodegenerative diseases. Magnetic susceptibility mapping is a novel, rapidly evolving quantitative technique with significant potential for assessing iron accumulation in the brain. \u0000AIM: The study aimed to determine changes in brain iron concentrations in patients with brain injury using magnetic susceptibility mapping techniques. \u0000MATERIALS AND METHODS: The study included 9 patients (14±2 years) with moderate and severe brain injury: three in the acute phase and six in the remote phase, and 4 healthy volunteers (15.3±0.9 years). All study participants underwent magnetic resonance imaging on a Philips Achieva dStream 3T scanner (Philips, the Netherlands). Data for magnetic susceptibility maps were acquired using a 3D FFE multi-echo sequence with flux compensation: FA=20, 6 TE: TE1/dTE=4.422 ms/5.795 ms, TR=59 ms (minimum), matrix size was 400×400×75, voxel size was 0.6×0.6×0.6 mm3. Magnetic susceptibility maps were generated using the SEPIA program. Magnetic field map construction, local magnetic field extraction, and magnetic susceptibility calculation were performed using the Laplacian, LBV, and iLSQR techniques, respectively. Average magnetic susceptibility values were obtained in 16 subcortical gray matter zones using the CIT168 atlas. \u0000RESULTS: The preliminary results of the study indicated that the patient group exhibited higher magnetic susceptibility values (p=0.07) in the compact part of the substantia nigra compared to the control group. The values for the patient and control groups were 0.03±0.03 and 0.003±0.018, respectively (Fig. 1). This result suggests a potential difference between the two groups at the level of a statistical trend, which may indicate iron accumulation in this area following brain injury. No changes in the values of magnetic susceptibility were observed in other areas of the subcortical gray matter that were investigated. \u0000An increased iron concentration in the compact part of the substantia nigra is also a characteristic of Parkinson’s disease [3]. This is consistent with the fact that brain injury is a risk factor for the development of this neurodegenerative disease. One of the possible causes of iron accumulation is neuronal death and increased permeability of the blood-brain barrier [4]. \u0000CONCLUSIONS: An elevated magnetic susceptibility value in the compact part of the substantia nigra in patients with brain injury may indicate the accumulation of iron in this area following injury. A larger sample size will allow for further testing of this hypothesis and the monitoring of changes in iron concentration over time following brain injury.","PeriodicalId":34831,"journal":{"name":"Digital Diagnostics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141680805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multiple biliary micro-hamartomas diagnosed in an unsuspecting elderly patient 一名毫无防备的老年患者被诊断出患有多发性胆道微小瘤
Pub Date : 2024-07-02 DOI: 10.17816/dd623322
Marina Balbino, Manuela Montatore, Giacomo Fascia, Ruggiero Tupputi, Federica Masino, Gianmichele Muscatella, Domenico Mannatrizio, Giuseppe Guglielmi
BACKGROUND AND AIM: Multiple biliary hamartomas are a benign incidental finding in the hepatic context. Recognizing them is not easy if one has never seen them and does not have access to the right imagery. The aim of the study is to expand the radiologist's digital image library, enabling a quick and precise differential diagnosis. Indeed, multiple biliary hamartomas can be challenging to differentiate from other liver lesions based on imaging alone. This case highlights the importance of thorough radiological assessment and the need for a multidisciplinary approach, involving radiologists, hepatologists, and pathologists, to ensure a precise diagnosis. METHODS: The patient in the study presented at the hospital for a CT scan and after an abdominal MRI recommended by his general practitioner to assess the biliary tree (Magnetic Resonance Cholangiopancreatography, MRCP) due to persistent abdominal pain. They had never undergone an abdominal MRI before in their life. The discovery of hepatic lesions was incidental and unexpected RESULTS: The MRI investigation revealed multiple benign lesions in both hepatic lobes compatible with the von Meyenburg complex. These lesions are multiple hamartomas and behave differently in all MRI sequences. CONCLUSIONS: The images acquired with the different MRI sequences were carefully examined. Despite being multiple and scattered throughout the liver, the lesions appeared immediately benign and consistent with the incidental diagnosis of multiple biliary hamartomas. Medical practitioners should be aware of the existence of multiple biliary hamartomas and consider them in the differential diagnosis when patients present with hepatic abnormalities. This knowledge can prevent unnecessary interventions and guide appropriate patient management.
背景和目的:多发性胆道火腿肠瘤是肝脏的良性偶然发现。如果从未见过它们,又没有合适的图像,识别它们并不容易。这项研究的目的是扩大放射科医生的数字图像库,以便快速准确地进行鉴别诊断。事实上,仅凭影像学检查很难将多发性胆道火腿肠瘤与其他肝脏病变区分开来。本病例强调了全面放射学评估的重要性,以及放射科医生、肝病专家和病理学家共同参与的多学科方法的必要性,以确保准确诊断。方法:研究中的患者因持续腹痛到医院进行 CT 扫描,之后在全科医生的建议下进行了腹部核磁共振成像,以评估胆道树(磁共振胆胰造影,MRCP)。在此之前,他们从未做过腹部核磁共振检查。结果:核磁共振成像检查发现,两个肝叶都有多发良性病变,符合冯-梅恩伯格综合征。这些病变为多发性仓瘤,在所有磁共振成像序列中表现不同。结论:对不同磁共振成像序列获得的图像进行了仔细检查。尽管病变是多发性的,且散布在肝脏各处,但病变看起来是良性的,符合多发性胆道火腿肠瘤的偶然诊断。医务工作者应了解多发性胆道火腿肠瘤的存在,并在患者出现肝功能异常时将其纳入鉴别诊断。这些知识可以避免不必要的干预,并指导对患者进行适当的管理。
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引用次数: 0
ORGANIZATION OF DISPENSARY OBSERVATION OF PATIENTS WITH PATHOLOGY OF THE MACULAR RETINA USING ARTIFICIAL INTELLIGENCE SYSTEMS 利用人工智能系统组织对黄斑视网膜病变患者的诊室观察
Pub Date : 2024-03-15 DOI: 10.17816/dd623956
Aleksandr Chuprov, Irina Pavlovna Bolodurina, A. O. Lositskiy, A. Zhigalov
Background: Despite the mention in the provision of medical care for diseases of the organ of vision, adnexa and orbit about equipping the medical consultative and diagnostic department of the clinic with an optical coherence tomograph, dynamic monitoring of patients with retinal pathology after the start of treatment is most often carried out in a medical ophthalmological center, which reduces accessibility for patients with primary (first identified) morbidity requiring initiation of treatment. The required technology needs to be changed, intensified, incl. using artificial intelligence technologies. Aim: development of methodological foundations for organizational technology for dispensary observation of patients with pathology of the posterior segment of the eye using clinical decision support system (CDSS) based on artificial intelligence. Materials and methods: The assessment of the existing regulatory framework was carried out on the basis of an analysis of the Constitution of the Russian Federation, Federal laws, by-laws, and judicial practice. The creation of a methodology for a structured medical document describing an optical coherence tomography image was carried out using an expert method: a survey of 100 ophthalmologists with the appropriate level of education, incl. additional professional, engaged in the provision of medical services - specialized medical care (treatment) to patients with pathology of the posterior segment of the eye. Results: Using an expert method, 123 binary signs were selected and described to describe the structure of the macular region of the retina in normal and pathological conditions, of which 26 signs were identified that can be interpreted as predictors of worsening of the clinical course of the disease. Conclusion: The developed classifier made it possible to create and train a medical decision support system based on 60,000 medical images, which, as an information service, without making a diagnosis, can change the organization of the dynamic observation process: the formation of patient routing - a primary service using the developed CDSS; if there are signs of deterioration in the clinical picture - routing to a medical ophthalmological center to assess the dynamics, provide specialized services, incl. high-tech medical care.
背景:尽管在为视力器官、附件和眼眶疾病提供医疗服务时提到要在诊所的医疗咨询和诊断部门配备光学相干断层扫描仪,但在开始治疗后,视网膜病变患者的动态监测通常是在眼科医疗中心进行的,这降低了需要开始治疗的原发性(首次发现的)发病患者的可及性。所需的技术需要改变和加强,包括使用人工智能技术。目的:利用基于人工智能的临床决策支持系统(CDSS),为在诊室观察眼球后段病变患者的组织技术奠定方法论基础。材料和方法:在分析《俄罗斯联邦宪法》、联邦法律、细则和司法实践的基础上,对现有监管框架进行了评估。采用专家方法制定了描述光学相干断层扫描图像的结构化医疗文件方法:对 100 名具有相应教育水平的眼科医生(包括其他专业人员)进行了调查,这些医生从事为眼球后段病变患者提供医疗服务--专业医疗护理(治疗)。结果:采用专家方法,选择并描述了 123 个二元征象,以描述正常和病理情况下视网膜黄斑区的结构,其中 26 个征象可被解释为疾病临床过程恶化的预兆。最后得出结论:该系统作为一种信息服务,在不做出诊断的情况下,可以改变动态观察过程的组织形式:形成病人路由--使用开发的 CDSS 的主要服务;如果临床症状有恶化迹象--路由到眼科医疗中心,以评估动态,提供专业服务,包括高科技医疗护理。
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引用次数: 0
Prospective evaluation of the extensibility of the ascending aorta wall and its vascular prosthesis in a patient with an aneurysm with technically flawless surgical correction and postoperative decrease in functional parameters. Clinical case and literature review. 对一名动脉瘤患者的升主动脉壁及其血管假体的延伸性进行前瞻性评估,手术矫正技术完美无瑕,术后功能参数下降。临床病例和文献综述。
Pub Date : 2024-03-13 DOI: 10.17816/dd568070
W. Y. Ussov, Aleksander Vladimirovich Friedmann, T. A. Bergen, A. R. Tarkova, A. M. Chernyavskiy, Irina Yur'evna Zhuravleva
A clinical case is presented and discussed when a patient with an instrumentally detected ascending aortic aneurysm with an expansion of the lumen up to 60 mm, after performing surgically flawless prosthetics, there was a marked decrease in exercise tolerance, a decrease in the contractile function of the left ventricular myocardium at rest, and an expansion of the pulmonary artery. It is shown that the leading factor was a decrease in the volume of systolic expansion of the aorta down to 5 ml, at the initial 13 ml, despite a noticeable increase in extensibility and a decrease in mechanical stiffness compared with initial indexes of the affected aortic wall. In this connection, the problems of creating aortic prostheses equivalent in terms of mechanical extensibility and elasticity to those for healthy biological tissues are discussed.
本文介绍并讨论了一例临床病例,该患者通过仪器检测到升主动脉瘤,管腔扩张达 60 毫米,在通过手术植入无暇假体后,运动耐力明显下降,静息时左心室心肌收缩功能下降,肺动脉扩张。结果表明,尽管主动脉壁的伸展性明显增加,机械僵硬度与受影响主动脉壁的初始指数相比有所下降,但主动脉收缩期的扩张量却从最初的 13 毫升下降到 5 毫升,这是导致主动脉收缩期扩张量减少的主要因素。在这方面,我们讨论了制作在机械伸展性和弹性方面与健康生物组织相当的主动脉假体的问题。
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引用次数: 0
Machine learning technology for predicting intraocular lens power. Diagnostics data generalization 预测眼内晶状体功率的机器学习技术。诊断数据通用化
Pub Date : 2024-03-13 DOI: 10.17816/dd623995
Александр Геннадьевич Арзамасцев, O. Fabrikantov, N. Zenkova, Sergey Belikov
Backgraund. Implantation of recent IOLs allows ophthalmologists to effectively solve the problems of surgical rehabilitation of patients with cataracts. The degree of improving the patient's visual functions is directly dependent on the accuracy of the preoperative calculation of the optical power of IOLs. The most famous formulas to calculate this indicator are SRK II, SRK/T, Hoffer-Q, Holladay II, Haigis, Barrett. All of them work well for an "average patient", however, they are not adequate enough at the boundaries of input variables ranges. Aims. To study the possibility of using mathematical models obtained as a result of deep learning of artificial neural networks (ANN models) to generalize data and predict the optical power of modern intraocular lenses. Materials and methods. ANN models were trained on large-scale samples, including depersonalized data for patients of ophthalmology clinic. Data provided in 2021 by ophthalmologist K.K. Syrykh, and reflect the results of both preoperative and postoperative observation of patients. The source file used to build the ANN model includes 455 records - 26 columns of input factors and one column for the output factor - calculating IOL (diopters). To conveniently build ANN models, we used a simulator program, previously developed by the authors. Results. The resulting models, in contrast to the traditionally used formulas, reflect the regional specificity of patients to a much greater extent. They also make it possible to retrain and optimize the structure based on newly received data, which allows taking into account the non-stationarity of the object. A distinctive feature of such ANN models in comparison with the well-known formulas SRK II, SRK/T, Hoffer-Q, Holladay II, Haigis, Barrett, widely used in the surgical cataract treatment in ophthalmology, is their ability to take into account a significant number of recorded input quantities, which makes it possible to reduce the mean relative error in calculating the optical power of IOL from 10–12% to 3.5%. Conclusions. This work shows the fundamental possibility of generalizing a significant amount of empirical data on calculating the optical power of the IOL using training ANN models that have a significantly larger number of input variables than when using traditional formulas and methods. The results obtained allow, in principle, to build an intelligent expert system with a continuous flow of new data from a source and a step-by-step retraining of the ANN model.
后视镜通过植入最新的人工晶体,眼科医生可以有效解决白内障患者的手术康复问题。患者视觉功能的改善程度直接取决于人工晶体光学功率术前计算的准确性。计算这一指标最有名的公式是 SRK II、SRK/T、Hoffer-Q、Holladay II、Haigis、Barrett。所有这些公式对 "普通患者 "都很有效,但在输入变量范围的边界上,它们就不够充分了。目的研究使用人工神经网络深度学习(ANN 模型)获得的数学模型来归纳数据和预测现代眼内透镜光学功率的可能性。材料和方法。在大规模样本(包括眼科诊所患者的非人格化数据)上训练 ANN 模型。数据由眼科医生 K.K. Syrykh 于 2021 年提供,反映了患者术前和术后的观察结果。用于建立 ANN 模型的源文件包括 455 条记录--26 列输入因子和一列输出因子--计算人工晶体(度数)。为了方便建立 ANN 模型,我们使用了作者之前开发的模拟器程序。结果。与传统的公式相比,所建立的模型更能反映患者的地区特异性。它们还能根据新收到的数据重新训练和优化结构,从而考虑到对象的非稳定性。与在眼科白内障手术治疗中广泛使用的著名公式 SRK II、SRK/T、Hoffer-Q、Holladay II、Haigis、Barrett 相比,这种 ANN 模型的一个显著特点是能够考虑大量记录的输入量,从而将计算人工晶体光学功率的平均相对误差从 10-12% 降低到 3.5%。结论。这项工作表明,与使用传统公式和方法相比,使用输入变量数量更多的训练方差网络模型,从根本上可以归纳计算人工晶体光学功率的大量经验数据。所获得的结果原则上允许建立一个智能专家系统,通过源源不断地获得新数据,并逐步重新训练 ANN 模型。
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引用次数: 0
Possibilities of using the virtual simulator "Vimedix 3.2" in the process of training in the specialty "ultrasound and diagnostics" 在 "超声波和诊断 "专业培训过程中使用虚拟模拟器 "Vimedix 3.2 "的可能性
Pub Date : 2024-03-11 DOI: 10.17816/dd586551
Valerii Vasilev, Svetlana Nikolaevna Kondrichina, Konstantin Borisovich Tsekhanovich
Background. In recent years, it is important to change the methods and programs of teaching many disciplines, including ultrasound diagnostics, with the inclusion of various virtual and simula-tion devices. The practical experience of using such technologies in the teaching process is rather short, therefore, there are few original works devoted to this topic in Russian and foreign literature.Aims. To determine the possibilities and algorithm of using virtual simulator of ultrasound re-search in the process of teaching the discipline of "ultrasound diagnostics" on the basis of the results of work with it. To evaluate the advantages and disadvantages of using simulator in comparison with traditional teaching methods.Material and methods. The results of using the virtual simulator "Vimedix 3.2" in the educa-tional process were analyzed. Simulations of transabdominal ultrasound examination of abdominal cavity organs, transthoracic echocardiography, triplex scanning of main vessels were performed on it. The study involved 26 residents in the specialty "ultrasound diagnostics", as well as 47 physicians who were trained at professional retraining courses.Results. The use of a virtual simulator at the initial stage in the training process can eliminate many of the problems that residents and trainees encounter in clinical sites. The use of a simulator in the testing process seems to be less favorable than a practical examination using ultrasound scanners and real patients.Conclusions. It is advisable to use the simulator at the initial stage to practice the research methodology. It is recommended to develop and use additional teaching materials and programs in training. The advantages of the virtual simulator are comfort of work at the initial stage of training, short time of its mastering, availability of an extensive database of pathological cases. The identified non-critical deficiencies require correction during further training in the clinic.
背景。近年来,包括超声诊断学在内的许多学科的教学方法和教学计划都必须改变,其中包括各种虚拟和模拟设备。在教学过程中使用此类技术的实践经验非常少,因此在俄罗斯和外国文献中很少有专门针对这一主题的原创作品。在 "超声波诊断学 "学科教学过程中,根据工作成果确定使用超声波再研究虚拟模拟器的可能性和算法。评估使用模拟器与传统教学方法相比的优缺点。分析了在教学过程中使用虚拟模拟器 "Vimedix 3.2 "的结果。在模拟器上进行了经腹超声检查腹腔器官、经胸超声心动图、主要血管的三重扫描。参与研究的有 26 名 "超声诊断 "专业的住院医生,以及 47 名在专业进修班接受过培训的医生。在培训过程的初始阶段使用虚拟模拟器可以消除住院医师和学员在临床现场遇到的许多问题。在测试过程中使用模拟器似乎不如使用超声扫描仪和真实病人进行实际检查。建议在初始阶段使用模拟器来练习研究方法。建议在培训中开发和使用额外的教材和程序。虚拟模拟器的优势在于培训初期工作舒适、掌握时间短、有大量病理病例数据库。已发现的非关键缺陷需要在临床进一步培训中加以纠正。
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引用次数: 0
Improving aortic aneurysm detection with artificial intelligence based on Chest CT data 利用基于胸部 CT 数据的人工智能改进主动脉瘤检测
Pub Date : 2024-03-11 DOI: 10.17816/dd569388
A. Solovev, Y. Vasilev, V. Sinitsyn, A. Petraikin, A. Vladzymyrskyy, I. Shulkin, D. Sharova, Dmitry S Semenov
Просьба см. прикреплённый файл с рукописью
请参见所附手稿文件
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引用次数: 0
期刊
Digital Diagnostics
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